• Title, Summary, Keyword: treatment delays

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Violence Episodes and Responses of Emergency Room Nurses (응급실 간호사가 경험한 폭력과 폭력반응에 관한 조사연구)

  • Kim, Su-Yon;Oh, Hee-Young;Ahn, Hye-Young;Eom, Mi-Ran
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.14 no.4
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    • pp.446-456
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    • 2007
  • Purpose: The purpose of study was to identify violence episodes by patients and/or their guardians and responses from emergency room nurses. Method: A convenient sample of 172 emergency nurses was selected from general hospitals with more than 200 beds. A survey design was used and data were collected from October 2 to October 11, 2006. using self-report questionnaires which were developed by the authors. Descriptive statistics, with the SPSS PC program were used to analyze the data. Results: The majority of nurses(97.1%) had experienced violence by patients or their guardians in the previous month. Violence offenders who were drunk comprised 68.6% of total offenders. Causes of violence were delays in examination and treatment(59.9%). The major coping behavior in dealing with violence episodes was ignoring(40.1%). Responses to violence experienced by emergency nurses were rated as 2.39. Response to violence according to general characteristics of the nurses showed no statistically significant differences. Conclusion: Considering the high prevalence of violence experienced by emergency nurses, hospitals must develop and manage preventive education programs and policy.

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Characteristics of Initiation and Termination of Tibialis Anterior Contraction in Adults With Hemiplegia: A Preliminary Study

  • Chung, Yi-Jung;Lee, Jung-Ah;Shin, Won-Seob;An, Seung-Heon;Lee, Eun-Woo;Jung, Kyoung-Sim
    • Physical Therapy Korea
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    • v.14 no.4
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    • pp.50-57
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    • 2007
  • The purpose of this study was to investigate the relationship between delays in initiation and termination of tibialis anterior contraction through surface electromyographic (sEMG) analysis in adults with hemiplegia and healthy subjects and clinical assessment of lower-limb mobility. EMG activity of 6 long-term survivors of stroke and 5 healthy subjects was recorded during maximal isometric ankle dorsiflexion in 3 seconds beeper signals. It must be done as fast and forcefully as possible. Lower limb mobility was assessed with Modified Emory Functional Ambulation Profile (mEFAP). Delay in initiation and termination of muscle contraction was significantly prolonged in the affected lower limb relative to the unaffected limb. Termination of muscle contraction in the hemiplegic lower limb was significantly delayed than the initiation on the affected sides. Delay in initiation and termination of muscle contraction correlated significantly with a few range of mEFAP. Abnormally delayed initiation and termination of muscle contraction may contribute to hemiparetic lower limb mobility in hemiparetic patients. Consequently, this study showed that abnormal delay of initiation and termination of muscle contraction may contribute to hemiparetic lower limb mobility in adults with hemiplegia. Further studies are needed to demonstrate a treatment effect.

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Analysis of Risk Control Options for Blockage Treatment (Subsea X-mas Tree에서의 Blockage 처리 실패에 대한 위험도 저감 방안 분석)

  • Yoo, Won-Woo;Park, Min-Sun;Yang, Young-Soon
    • Journal of Ocean Engineering and Technology
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    • v.27 no.2
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    • pp.47-52
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    • 2013
  • A subsea chemical injection system treats blockage problems in a subsea production system. It is important to treat problems quickly, because production delays cause fatal profit losses in a subsea production system. Therefore, the subsea industry requires a relatively higher reliability level for a production system compared to other industries. In this study, a subsea chemical injection system (linked to a control system) to inject chemicals into a subsea X-mas tree was analyzed. By using FSA (Formal Safety Assessment), the risk factors were defined and a quantitative risk analysis utilizing FTA (Fault Tree Analysis) and ETA (Event Tree Analysis) was performed. As a result, the effectiveness of a risk reduction option was evaluated.

Tuberculosis-associated hemophagocytic lymphohistiocytosis in adolescent diagnosed by polymerase chain reaction

  • Seo, Ju-Hee;Lee, Jun Ah;Kim, Dong Ho;Cho, Joongbum;Lim, Jung Sub
    • Clinical and Experimental Pediatrics
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    • v.59 no.1
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    • pp.43-46
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    • 2016
  • We present a case of tuberculosis-associated hemophagocytic lymphohistiocytosis in a 14-year-old girl. The patient presented with weight loss, malaise, fatigue, prolonged fever, and generalized lymphadenopathy. Laboratory investigation revealed pancytopenia (white blood cells, $2,020cells/{\mu}L$; hemoglobin, 10.2 g/dL; platelets, $52,000cells/{\mu}L$), hypertriglyceridemia (229 mg/dL), and hyperferritinemia (1,420 ng/mL). Bone marrow biopsy showed a hypocellular bone marrow with a large numbers of histiocytes and marked hemophagocytosis; based on these findings, she was diagnosed with hemophagocytic lymphohistiocytosis. Polymerase chain reaction (PCR) with both the bone marrow aspiration and sputum samples revealed the presence of Mycobacterium tuberculosis. Antitubercular therapy with immune modulation therapy including dexamethasone and intravenous immunoglobulin was initiated. The results of all laboratory tests including bone marrow biopsy and PCR with both the bone marrow aspiration and sputum samples were normalized after treatment. Thus, early bone marrow biopsy and the use of techniques such as PCR can avoid delays in diagnosis and improve the survival rates of patients with tuberculosis-associated hemophagocytic lymphohistiocytosis.

Complementary Alternative Medicine Use Amongst Breast Cancer Patients in the Northern Region of Peninsular Malaysia

  • Knight, Aishah;Hwa, Yen Siew;Hashim, Hasnah
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.8
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    • pp.3125-3130
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    • 2015
  • Background: Breast cancer is a common cancer affecting women in Malaysia and the use of complementary/alternative medicine (CAM) has been associated with delays in getting treatment. The aim of the study was to explore the use of CAM and the influencing factors in the Northern region of Peninsular Malaysia. Materials and Methods: This was a cross-sectional descriptive study on a convenience sample of 100 Malaysian breast cancer survivors. Findings: The reported use of CAM among the breast cancer survivors was lower than in other studies but the types of CAM used had a similar pattern with nutrition supplements/vitamins being the most common. The factors that positively influenced the use of complimentary/traditional therapy were income and getting information from television or radio. Survivors with access to internet/blogs appear to have lower odds of using complimentary/traditional therapy compared to the respondents who reported no such access. Conclusions: Information transmitted via television and radio appears to have a positive influence on CAM use by breast cancer patients compared to other information sources and it is important to ensure that such information is accurate and impartial.

Regulation Issues in Korea and Technical Feasibility Evaluation of 3D Printing-Based Medical Device Repair (3D 프린팅 기술의 의료기기 수리 적용에 대한 국내 규제 이슈 및 기술적 적합성 평가)

  • Yun, Sung Uk;Nam, Kyoung Won
    • Journal of Biomedical Engineering Research
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    • v.41 no.2
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    • pp.75-83
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    • 2020
  • In large-scale hospitals, the department of biomedical engineering should always provide quick repair service for damaged medical devices to guarantee continuous patient treatment. However, in actual circumstances, there are so many time-consuming issues that delays device repair for weeks or even months; therefore, it is required to prepare alternative ways for quick repair service. In this study, we first mentioned about the regulation issues in Korea about the 3D printing-based medical device repair, and then introduced the results of our preliminary study that evaluated the feasibility of 3D printing-based medical device repair before real-field application. Results of the study demonstrated that, in all of the 23 cases, parts for repair that were manufactured by 3D-printing were successfully fixed and connected to the main body of the original device, and showed sufficient rigidity for protecting internal parts of the device. Considering the experimental results, medical device repair by applying 3D printing technology can be a promising alternative in cases when regular repair process is not available or takes too much time.

Effect of Granulocyte-Macrophage Colony-Stimulating Factor (GM-CSF) on Neutropenia Occuring during Radiotherapy (GM-CSF가 방사선 치료시 발생한 호중구감소증에 미치는 영향)

  • Jang Ji Young;Choi Ihl Bohng;Chung Su Mi;Kim In Ah;Kay Chul Seong;Kim Chun Chu;Shin Kyung Sub
    • Radiation Oncology Journal
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    • v.13 no.1
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    • pp.79-85
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    • 1995
  • Purpose : To assess the efficacy of recombinant human granulocyte-macrophage colony-stimulating factor(GM-CSF) in the neutropenia by radiotherapy. Materials and Methods : Eleven patients with various solid tumor were treated with a daily subcutaneous dose of GM-CSF(3-7microgram/kg) for 5days during the radiotherapy. Before and during the course of the study all the patients were monitored by the recording of physical examination, the complete blood count with differential and reticulocyte count and liver function test. Eight patients received prior or concurrent chemotherapy. Results : In 10 patients, the neutrophilic nadir was significantly elevated and the lenght of time that Patients had a neutrophil count below $10^3/mm^3$ a threshold known to be critical to acquiring infective complications was shortened following GM-CSF injection. A significant rise (two fold or greater) of neutrophil count was seen in 10 of 11 patients. In most patients, discontinuation of GM-CSF resulted in a prompt return of granulocyte counts toward baseline. However the neutrophil count remained elevated over $10^3/mm^3$ during radiation therapy, and radiotherapy delays were avoided. Other peripheral blood components including monocytes and platelets also increased after GM-CSF treatment. No significant toxicity was encountered with subcutaneous GM-CSF treatment. Conclusion : GM-CSF was well tolerated by subcutaneous route and induced improvement in the neutropenia caused by radiotherapy.

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Development of Critical Paths for Appendectomy (표준 진료 지침서(Critical Paths) 개발에 관한 연구 - 충수절제술(Appendectomy) 환자용 -)

  • Kim, Yong-Soon;Park, Jee-Won;Park, Yon-Ok;Cho, Eun-Sook;Kim, Myung-Wook
    • Quality Improvement in Health Care
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    • v.2 no.2
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    • pp.32-45
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    • 1996
  • Background : A critical path defines an optimal sequencing and timing of interventions by physicians, nurses, and other staff for a particular diagnosis or procedure, designed to better utilize resources, maximize quality of care, and minimize delays. It can be thought of as a visualization of the patient care process. In this study, a review of appendectomy patient records was undertaken to identify a critical path for the management of this treatment. Methods: For this study, records of patients under 15 or over 65 years of age were excluded ; cases where the patient was pregnant, or where complications developed were also excluded. The remaining 21 cases were divided into two categories according to the indication for appendectomy : for acute appendicitis, and for perforated appendix or drainage of periappendical abscess. The time frame for the review was from patient examination immediately prior to operation, through discharge. The study team was composed of a surgeon, research head nurse, education head nurse, surgical part head nurse, and medical recorder. Following their review of the 21 charts, the team determined an appropriate progression and schedule for an appendectomy. Result : Through the chart and literature review, the following aspects of the care process were identified as typical and tracked : monitoring/assessment, treatment, lines/drains, medication, activity, diet, tests and patient education. Conclusion : From this study, the design team determined two separate critical paths : one for appendectomy only, and one for appendectomy plus drainage. Next, these paths must be validated and fine-tuned through clinical implementation. In addition, a comparison of our design with the critical paths determined at other hospitals would be extremely valuable for advancing research in this area. Lastly, the critical path approach to improving patient care and maximizing hospital resources should be applied to other procedures.

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A Case Report of a Patient with Chemotherapy-induced Leukopenia Treated with Acupuncture (항암화학요법으로 인한 백혈구감소증 환자의 침 치료 증례 보고)

  • Choi, Jin-yong;Cho, Jae-hyun;Bae, Go-eun;Shim, So-hyun;Seo, Hee-jeong;Choi, Jun-yong;Kwon, Jung-nam;Lee, In;Hong, Jin-woo;Yun, Young-ju;Park, Seong-ha;Kim, So-yeon;Han, Chang-woo
    • The Journal of Internal Korean Medicine
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    • v.38 no.5
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    • pp.806-811
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    • 2017
  • Leukopenia is a commonly encountered adverse event experienced by cancer patients. It can cause serious infections and delays in chemotherapy. We describe a case of leukopenia induced by colon cancer chemotherapy. After acupuncture treatment, the patient showed improvement in the leukopenia and completed the scheduled chemotherapy without delay or additional administration of granulocyte colony-stimulating factor (G-CSF). Therefore, acupuncture may have a substantial benefit for treatment of leukopenia in this patient.

Factors Influencing Ventilator-Associated Pneumonia in Cancer Patients

  • Park, Sun-A;Cho, Sung Sook;Kwak, Gyu Jin
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.14
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    • pp.5787-5791
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    • 2014
  • Background: With increasing survival periods and diversification of treatment methods, treatment of critically ill cancer patients has become an important factor influencing patient prognosis. Patients with cancer are at high risk of infections and subsequent complications. This study investigated the incidence and factors contributing to the development of ventilator-associated pneumonia (VAP). Materials and Methods: This retrospective study investigated the incidence of VAP and factors leading to infection in patients admitted to the intensive care unit (ICU) of a cancer center from January 1, 2012 to December 31, 2013. Results: The incidence of VAP was 2.13 cases per 1,000 days of intubation, and 13 of 288 patients (4.5%) developed VAP. Lung cancer was the most common cancer associated with VAP (N=7, 53.9%), and longer hospital stays and intubation were associated with increased VAP incidence. In the group using a "ventilator bundle," the incidence was 1.14 cases per 1,000 days compared to 2.89 cases per 1,000 days without its use; however, this difference was not statistically significant (p=0.158). Age (${\geq}65$, OR=5.56, 95% confidence interval [CI]=1.29-23.95), surgery (OR=3.78, 95%CI=1.05-13.78), and tracheotomy (OR=4.46, 95%CI=1.00-19.85) were significant VAP risk factors. The most common causative organisms were methicillin-resistant Staphylococcus aureus (MRSA) and Pseudomonas aeruginosa (N=4, 30.8% each), followed by Acinetobacter baumannii and Candida albicans (N=2, 15.4% each). Conclusions: The incidence of pneumonia among critically ill cancer patients is highest in those with lung cancer, but lower than among non-cancer patients. The length of hospital stay and time on mechanical ventilation are important risk factors for development of VAP. Although not statistically significant, "ventilator bundle" care is an effective intervention that delays or reduces incidence of VAP. Major risk factors for VAP include age (${\geq}65$ years), surgery, and tracheostomy, while fungi, gram-negative bacteria, and multidrug-resistant organisms were identified as the major causative pathogens of VAP in this study.